Infectious and noninfectious endophthalmitis after intravitreal high-dosage triamcinolone acetonide

PURPOSE: To evaluate the rate of infectious and noninfectious endophthalmitis after intravitreal injection of a high-dosage of triamcinolone acetonide. DESIGN: Clinical interventional case-series study. METHODS: The study included 1135 intravitreal injections of approximately 20 mg triamcinolone performed for 915 eyes with diabetic macular edema (n = 257), exudative age-related macular degeneration (n = 561), retinal vein occlusions (n = 82), and other reasons. Among the injections were 220 reinjections. Triamcinolone was filtered to remove the solvent agent. Mean follow-up was 8.1 +/- 7.4 months. RESULTS: In none of the eyes, signs of an infectious or noninfectious endophthalmitis were observed such as noncrystalline hypopyon, cellular infiltration, or amorphous opacification of the vitreous, retinal infiltration, or pain. One patient developed infectious endophthalmitis 2 days after a traumatic rupture of a previous corneoscleral cataract incision. CONCLUSIONS: The rate of infectious or noninfectious endophthalmitis after an intravitreal high-dosage triamcinolone injection may be approximately 1:1000, if the solvent agent was removed.